When the first patients in Sweden received single dental implants in the early 1980s, no one knew if they’d last. Titanium screws anchored into jawbones sounded like science fiction at the time. Four decades later, those same implants are still in place—and still doing their job.

A new study from the University of Gothenburg reports the world’s longest follow-up of single dental implants: nearly forty years. Researchers tracked 13 patients, all of whom received implants between 1982 and 1985. The results are striking. Every one of the 18 implants examined remains functional, with bone around them virtually unchanged.

“It is impressive that the single implants function so well after such a long time,” said Sargon Barkarmo, prosthodontist and senior lecturer at the University of Gothenburg, in the press release. “Even though the study included a small number of patients, the results show that the implants remain in place and that the bone loss around them is virtually unchanged after forty years. This confirms that the foundation Brånemark established still holds.”

A foundation in titanium

Dental implants, as we know them, began with Professor Per-Ingvar Brånemark, who discovered that bone could fuse with titanium. His breakthrough in osseointegration revolutionized dentistry. Millions of patients have since benefited from implants that mimic natural tooth roots.

The Gothenburg study, published in Clinical Implant Dentistry and Related Research, shows that the stability of titanium dental implants is outstanding. Of the original 23 implants placed, 18 remain after 38–40 years, giving them a survival rate of 95.6%

The real issue lies with crowns—the visible ‘teeth’ attached to those implants—which don’t last as long. Only 60 percent of the original crowns were still in place after four decades. Most were swapped out for aesthetic reasons rather than technical failures.

“The study shows that the crowns were mostly replaced for aesthetic reasons rather than technical failures,” said Jan Kowar, prosthodontist and co-author of the study. “In the future, implant treatments could be further improved with the development of new crown materials.”

The long game in oral health

The patients in this study were unusually young when they received implants, on average, just 23 years old. Many had lost teeth from trauma or congenital absence. Because they were so young, researchers had the rare chance to see how implants perform over a lifetime.

The results suggest that patience was key. Back in the 1980s, implants were placed with long healing times: two surgeries spaced months apart, with full loading happening almost a year after the first operation. Today’s methods often aim to speed things up, which could come at a cost, says Barkarmo. “Today, methods that accelerate treatment and healing are commonly used. These approaches also need long-term follow-ups and careful evaluation to ensure equally good results over time.”

In fact, the study found that bone levels around the implants barely changed in four decades—and in some cases, bone had even grown. That stability was paired with low complication rates. Mucositis, a mild gum inflammation, was common. But the dreaded peri-implantitis, which can lead to implant failure, never appeared.

Implant dentistry today isn’t just about replacing a lone missing tooth. Techniques such as the “all-on-4” method allow patients who have lost most or all of their teeth to walk out of surgery with a fully restored smile anchored by just four implants.

“All-on-4 implants have transformed treatment for patients with extensive tooth loss. They provide stability and confidence in a fraction of the time older methods required. But as this new research shows, we can’t forget the importance of long-term monitoring. Even when implants last decades, crowns and gums need attention,” said Dr. Elif Demir at the Parmire Dental Centre in Turkey, where these procedures are increasingly common.

Why it matters

Dentistry often focuses on the immediate fix. Think of a chipped tooth, a missing molar, or a quick replacement. But this study reminds us that, when done carefully, implant treatments can last not just years, but entire generations.

There’s a catch. The implants in this study used designs no longer on the market. New systems constantly replace older ones, sometimes before long-term data emerges. Patients and dentists alike are left to hope the latest designs prove as durable as Brånemark’s originals.

Elsewhere, scientists are working on the next generation of therapies for missing teeth. Rather than using metal implants, the focus is now on regenerating new teeth for the patient. Earlier this year, scientists at Tufts University grew human-like teeth inside the jaws of pigs, an early step toward replacing your missing teeth with biological dentition.